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Changing performance of the Health Visitor Distraction Test when targeted neonatal screening is introduced into a
S Wood1, A C Davis, B McCormick
1Children's Hearing Assessment Centre, Queen's Medical Centre University Hospital, Nottingham, UK.
Insights
Neonatal hearing screening led to more referrals but decreased the effectiveness of the Hearing Vision Development Test (HVDT) over time. Sensitivity dropped significantly, impacting early detection of hearing loss in newborns.
Area of Science:
- Audiology
- Neonatal Care
- Public Health Screening
Background:
- Introduction of targeted neonatal hearing screening programs.
- Established hearing loss threshold of > or = 50 dB in the better ear for analysis.
- Focus on the Nottingham district for the period 1984-1993.
Purpose of the Study:
- To examine changes in Hearing Vision Development Test (HVDT) performance.
- To evaluate the impact of introducing neonatal hearing screening on HVDT effectiveness.
- To analyze referral routes and screening test results for children with hearing loss.
Main Methods:
- Retrospective review of records for children born 1984-1993 in Nottingham.
- Inclusion criteria: permanent hearing loss >= 50 dB in the better ear.
- Analysis of referral pathways and HVDT screening outcomes.
Main Results:
- Increased referrals prior to HVDT, primarily due to neonatal screen failures.
- Significant reduction in HVDT sensitivity: 78% (1984-1988) to 38% (1989-1993).
- Indications of increased screening coverage and higher failure rates over the study period.
Conclusions:
- Neonatal screening influenced referral patterns and HVDT performance.
- Declining HVDT sensitivity suggests potential challenges in early hearing loss detection.
- Further investigation into reasons for performance changes and screening effectiveness is warranted.
Abstract:
The change in the performance of the HVDT as targeted neonatal hearing screening has been introduced has been examined for the Nottingham district. The records for all children born in the period 1984-1993 within the district and having a permanent hearing loss of > or = 50 dB in the better ear have been examined. The referral route leading to ascertainment of the hearing loss as well as the result of any screening tests were noted. The data shows an increase in the number referred prior to the HVDT, mainly as a result of neonatal screen failure. At the same time there has been a reduction in the sensitivity of the HVDT from 78% in the first half of the decade to 38% for the second half. There are also some indications of an increase in the coverage and the failure rate over the time. Possible reasons for these changes are discussed.